[Results of simple trabeculectomy and that combined with extraction of the crystalline lens in glaucoma in the adult].
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Biomedical subjects
Publications and source records attributed to G Offret.
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Trabeculectomy, an operation of relatively easy technique, is effective on the intra-ocular pressure in 93,5 p.100 of cases in our statistics. It does not alter the vision and in some cases improves it, and carries few post-operative complications. A flat anterior chamber, whose frequency varies according to the indications, is seldom severe. It appeared however as a frequent complication in closed angle glaucoma (30 p. 100), and in secondary glaucoma (14 p. 100), more frequently than in chronic open angle glaucoma (8 p. 100). Other complications are rare. Trabeculectomy, as a specific fistulising procedure, in fact appears to us to be one of the best antiglaucomatous surgical operations.
In a study of lens opacification following trabeculectomy in 95 cases observed for 6 months to 2 1/2 years. 28 per cent were found to have lens opacities within an average of one year. Post-opérative complications do not determine the development of cataracts, but they are a predisposing factor chiefly acting on the delay in opacification. It seems that the contribution of trabeculectomy in reducing the frequency of flat anterior chambers and prolonged hypotony when compared with the classical fistulising operations, can only delay the appearance of post-operative cataracts without diminishing the frequency. This frequency reaches 50 per cent after the age of 70 in the same titre as the classical fistulising procedures.
A composite review of 24 cases of embryonal rhabdomyosarcoma which is seen in fact to be the commonest orbital malignant tumour in children. In its evolution, most often very rapid, sometimes pseudo-inflammatory, this tumour presents many different histological appearances among which the alveolar form and the botryoidal form should be particularly distinguished. Although it was for a long time confused with reticulosarcoma the tumour is in fact derived from primitive undifferentiated mesenchymal cells and can therefore in this sense be considered as a blastoma. Since the prognosis is grave and its treatment often disappointing, it should in many cases combine surgery with radiotherapy and polychemotherapy.
The angiomas of orbital walls are very rare. The authors report a case of cavernous angioma growing into the external orbital wall in a young girl. The surgical excision of this angioma after embolization of the arterial supply of the tumor permits a plastic reconstruction of the orbital wall with good result.
A study of 11 cases of iridocycloretraction carried out in aphakic glaucoma. The surgical technique is described is described together with the results and complications. The only technical difficulty is the invagination of the scleral tongues. The principle complication is hyphaema which does not alter the definitive tonometric result which was good in 5 cases. The effect on pressure seemed to be related to the maintenance of the scleral implants in the angle. Aqueous outflow occurred through the cyclodialysis.
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A report on two cases of long-term recurrence of mixed tumours of the lacrimal glands. The authors assess the problem of the protracted evolution of these tumours and their possible degeneration, and attempt to distinguish the degeneration which follows multiple recurrences of co-existing mixed carcinomatous tumours. They insist on the necessity in these cases of an initial wide neurosurgical exposure of the orbit, so as to perform the widest excision possible.
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